Implementation of Global Hearts Hypertension Control Programs in 32 Low- and Middle-Income Countries
Authors: Andrew E. Moran, Reena Gupta, Anupam Pathni, Kufor Osi, Girma Dessie, Xiulei Zhang, Danielle Cazabon, Bolanle Banigbe, Margaret Farrell, Okeoma Erojikwe, Swagata Swahoo, Ashish Krishna, Abdikaid Ahmed Yusuf, Henok Gebreyohannes Kebede, Molla Gedefaw Berhanu, Tilahun Bezabih, Teshome Ayalew Tegegn, Workneh Demissie, Daniel Burka, Misu Tasmin, Bolatito Ogbeide, Timothy Cheadle, Joseph Odu, Meron Hailu Beyene, Cecile Borkhataria, Kate Elliott, Marc Jaffe, Renu Garg, Thomas R. Frieden, Taskeen Khan, Slim Slama, Bente Mikkelson, Truong Duc Lai, Rauell John Santos, Tyrone Aquino, Dofel Joseph Calla, Abhishek Kunwar, Kiran Durgad, Sushera Bunluesin, Mary Dewan, C.E. Obagha, Kelias Msyamboza, Bidisha Das, Navneet Kishore, Yannick Poulose Puthussery, Gopinath Thirugnana Sambandam, A Branch Immanuel, Chakshu Chandrakant Joshi, Rupali Bhardawaj, Amol Wankhede, Suhas Namdevrao Khedkar, Vishwajit Washudeorao Bhardawaj, Thokala Sravan Kumar Reddy, Tejpalsinh Anandrao Chavan, Raghavendra Patel Chittimella, Subhasis Bhandari, Urvin Kumar Shah, Deenadayalan Chandram, Mohammed Abdul Wassey, Abhinav Kadia, Lalit Dinkar Sarode, Lalita Chauhan, Satyendra Nath Ponna, Suresh Babu, Piyush Gupta, Thej Kiran Reddy, Hanspreet Sekhon, Asif Jeelani, Gunjan Nath, Virendra Wankhede, Niniya Jayaprasad, Trishna Mohanty, Praveen Kumar, Abhishek Khanna, Shweta Singh, Ashish Bhat, Jatin Thakkar, Aiswarya Lakshmi Anitha Sreekumar, Ravivarman Lakshmanasamy, Mohamed Essa Rafique, Sunil Kumar Dar, Sreedhar Chintala, Bharath Jagadeesh, Manoj Patruni, Madhur Raimule, Shahanara S. Prabhu Valawalkar, Pedro Ordunez, Gloria Giraldo, Ramon Martinez, Andres Rosende, Yenny Rodriguez, Cintia Lombardi, Angelo Gamarra, Libardo Rodriguez, Natalia Parra, Gonzalo Rodriguez, Noelia Villalta, Maria C. Escobar, Nilda Villacres, Carlos Sorto, Edith Baca, Vhania Batista, Vivian Perez, Jorge Victoria, Zohra Abaakouk, Taraleen Malcolm, Deliana Kostova, Patricia Richter, Paul K. Whelton, Daniel Lackland, Michael Weber, Daniel Pineiro, David Wood, Fausto Pinto, Jeremiah Mwangi, Pablo Perel, Elisa Codato, Jean-Luc Eiselé, Prabhdeep Kaur, Ganeshkumar Parashuraman, Meenakshi Sharma, Roopa Shivashankar, Sampada Dipak Bangar, Tapas Chakma, Pragati Pragya, Abdul Malik, Khondker Abdul Awal, Fazilatunnesa Malik, Sohel Reza Choudhury, Mahfuzur Rahman Bhuiyan, Shamim Jubayer, Mohammad Abdullah Al Mamun, Mir Ishraquzzaman, Ahmed Khairul Abrar, Jubaida Akhter, Sarmin Sultana, Aslam Parvej, Noor Nabi Sayem Khandoker Ehsanul Amin, Md Shahinul Islam, Deb Dulal Dey Parag, Ruhul Amin, Mahfuja Luna, Md Abbas Ibn Karim, Progga Mahajabin, Iqbal Ahmed Khan, Sazzad Hossain, Riasat Razi Ullah, Muhtamim Fuwad Nahid, Xinhua Zhang, Hongxia Huang, Hao Wang, Tingrui Guan, Haiying Zhao, Dike Ojji, Gabriel Lamkur Shedul, Grace Shedul, Anthony Orji, Regina Asuku, Confidence Alo-Joseph, Charity Akor, Nonye Egenti, Ada Nwankwo, Kasarachi Omitiran, Rosemary Okoli, Nanna Ripiye, Blessing Akor, Jun Cai, Lu Wang, Wenjie Wang, Luyun Fan, Jianrong (Jenny) Xu, Shanshan Tang, Guoli Wu, Barbara Smith, Thomas Kenyon, Sudarsan Mandal, Sunny Swarnakar, S.C. Wickramasinghe, Amila Bandarra Herath, I.U. Ratnayake, Kosala Samarasinghe, K.H.N. Kumarasiri, S.C. Wickramasinghe, Natalia Vensentini, Daniel Palacios Mendieta, Marcela Rivera, Yamile Valdez Gonzalez, Lucia Cevallos, Matías Humberto Villatoro, Laura Elena Gloria Hernandez, Elsa Arenas, Daniel Fernández, Daniel Mola De Oleo, Shana Cyr, Roxanne Mitchell, AHM Enayet Hossain, Mohammad Robed Amin, Abdul Alim, Sarowar Uddin Milon, M.O. Alex-Okoh, D.O. Odoh-Bako, M.T. Malau, B.R. Oshundele, O.K. Akinkoye, E.A. Abraham, S.V. Eze, Chris Elemuwa, Suleiman Lamorde, E.A. Oguntayo, Ashiru Rajab, Auwalu Ibrahim, Festus Soyinka, Maria Elizabeth Caluag, Maria Rosario Uy, Regional Director Adriano Subaan, Aimee Marie Gayomali, John Richard Lapascua, Hiwot Solomon Taffese, Truong Dinh Bac, Tran Quoc Bao, Xiaolei Guo, Chunxiao Xu, Bingyin Zhang, Nguyen Thi Thi Tho, Ngo Hai Van, Phan Cong Danh, Ho Huu Tinh, Tran Phuc Hau, Lawrence J. Appel, Kunihiro Matsushita, Katye Andersen, Christabelle Ayensu-Asiedu, Samuel Byiringiro, Tammy Brady, Jeanne Charleston, Mengkun Chen, Yvonne Commodore–Mensah, Arlene Dalcin, Cheryl Dennison-Himmelfarb, Ning Ding, Christopher K. Doyle, Anbrasi Edward, Sabrina de Souza Elias, Kathryn Foti, Raquel Greer, Megan Henry, Xiao Hu, Junichi Ishigami, Minghao Kou, Katherine Lord, Yifei Lu, Matti Marklund, Pablo Martinez Amezcua, Joey Mattingly, Kristin McArthur, Edgar R. Miller, Dinesh Neupane, Bunmi Ogungbe, George Pariyo, Priya Pathak, Scott Pilla, Krishna Rao, Carol Resnick, Kristin Riekert, Tangkwa Sakulsaengprapha, Simona Scheiber, Nicole Shilkofski, Steve Tamplin, Olive Tang, Di Zhao, Norman Campbell, Olugbenga Ogedegbe, Donald Di Pette, Jeffrey Brettler, Kenneth Connell, Sandeep P. Kishore, Mark Huffman, Brian Hutchinson, Marwa Abdalla
Journal: Journal of the American College of Cardiology (2023)

In 2017, the World Health Organization (WHO) and Resolve to Save Lives partnered with country governments and other stakeholders to design, test, and scale up the WHO HEARTS hypertension services package in 32 low- and middle-income countries. Facility-based HEARTS performance indicators included number of patients enrolled, number treated and with blood pressure controlled, number who missed a scheduled follow-up visit, and number lost to follow-up. By 2022, HEARTS hypertension control programs treated 12.2 million patients in 165,000 primary care facilities. Hypertension control was 38% (median 48%; range 5%-86%). In 4 HEARTS countries using the same digital health information system, facility-based control improved from 18% at baseline to 46% in 48 months. At the population level, median estimated population-based hypertension control was 11.0% of all hypertension patients (range 2.0%-34.7%). The Global Hearts experience of implementing WHO HEARTS demonstrates the feasibility of controlling hypertension in low- and middle-income country primary care settings.